Tissue Doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy.
J Am Coll Cardiol
; 40(4): 723-30, 2002 Aug 21.
Article
em En
| MEDLINE
| ID: mdl-12204503
ABSTRACT
OBJECTIVES:
We sought to evaluate the long-term impact of cardiac resynchronization therapy (CRT) on left ventricular (LV) performance and remodeling using three-dimensional echocardiography and tissue Doppler imaging (TDI).BACKGROUND:
Three-dimensional echocardiography and TDI allow rapid and accurate evaluation of LV volumes and performance.METHODS:
Twenty-five consecutive patients with severe heart failure and bundle branch block who underwent biventricular pacemaker implantation were included. Before and after implantation of the pacemaker, three-dimensional echocardiography and TDI were performed. These examinations were repeated at outpatient visits every six months.RESULTS:
Five patients (20%) died during one-year follow-up. In the remaining 20 patients, significant reductions in LV end-diastolic volume and LV end-systolic volume of 9.6 +/- 14% and 16.5 +/- 15%, respectively (p < 0.01), could be demonstrated during long-term follow-up. Accordingly, LV ejection fraction increased by 21.7 +/- 18% (p < 0.01). According to a newly developed TDI technique-tissue tracking-all regional myocardial segments improved their longitudinal systolic shortening (p < 0.01). The extent of the LV base displaying delayed longitudinal contraction, as detected by TDI before pacemaker implantation, predicted long-term efficacy of CRT. The QRS duration failed to predict resynchronization efficacy.CONCLUSIONS:
Cardiac resynchronization significantly improved LV function and reversed LV remodeling during long-term follow-up. Patients likely to benefit from CRT can be identified by TDI before implantation of a biventricular pacemaker.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sístole
/
Bloqueio de Ramo
/
Estimulação Cardíaca Artificial
/
Remodelação Ventricular
/
Insuficiência Cardíaca
Tipo de estudo:
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2002
Tipo de documento:
Article